Guideline adherence and survival of patients with candidaemia
in Europe: results from the ECMM Candida III multinational
European observational cohort study

J 2023

Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study

HOENIGL, Martin, Jon SALMANTON-GARCÍA, Matthias EGGER, Gangneux JEAN-PIERRE, Tihana BICANIC et. al.

Basic information

Original name

Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study

Authors

HOENIGL, Martin (guarantor), Jon SALMANTON-GARCÍA, Matthias EGGER, Gangneux JEAN-PIERRE, Tihana BICANIC, Sevtap ARIKAN-AKDAGLI, Ana ALASTRUEY-IZQUIERDO, Nikolai KLIMKO, Aleksandra BARAC, Volkan ÖZENCI, Eelco F J MEIJER, Nina KHANNA, Matteo BASSETTI, Riina RAUTEMAA-RICHARDSON, Katrien LAGROU, Adam KAI-MANUEL, Emin Halis AKALIN, Murat AKOVA, Valentina Arsic ARSENIJEVIC, Avinash AUJAYEB, Ola BLENNOW, Stéphane BRETAGNE, François DANION, Blandine DENIS, Nick Alexander de JONGE, Guillaume DESOUBEAUX, Lubos DRGONA, Nurettin ERBEN, Andrea GORI, Julio García RODRÍGUEZ, Carolina GARCIA-VIDAL, Daniele Roberto GIACOBBE, Anna L GOODMAN, Petr HAMAL, Helena HAMMARSTRÖM, Cristina TOSCANO, Fanny LANTERNIER, Cornelia LASS-FLÖRL, Deborah E A LOCKHART, Thomas LONGVAL, Laura LOUGHLIN, Tadeja MATOS, Malgorzata MIKULSKA, Manjusha NARAYANAN, Sonia MARTÍN-PÉREZ, Juergen PRATTES, Benedict ROGERS, Laman RAHIMLI, Maite RUIZ, Emmanuel ROILIDES, Michael SAMARKOS, Ulrike SCHARMANN, Uluhan SILI, Oguz Resat SIPAHI, Alena SIVÁKOVÁ (203 Czech Republic, belonging to the institution), Joerg STEINMANN, Janina TRAUTH, Ozge TURHAN, Jens Van PRAET, Antonio VENA, P Lewis WHITE, Birgit WILLINGER, Anna Maria TORTORANO, Maiken C ARENDRUP, Philipp KOEHLER and Oliver A CORNELY

Edition

The Lancet Infectious Diseases, OXFORD, ELSEVIER SCI LTD, 2023, 1473-3099

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30303 Infectious Diseases

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 56.300 in 2022

RIV identification code

RIV/00216224:14110/23:00130480

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/S1473-3099(22)00872-6

UT WoS

001023025000001

Keywords in English

candidaemia; Europe

Abstract

V originále

Background The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, treatment, and outcomes of patients with culture-proven candidaemia across Europe to assess how adherence to guideline recommendations is associated with outcomes. Methods In this observational cohort study, 64 participating hospitals located in 20 European countries, with the number of eligible hospitals per country determined by population size, included the first ten consecutive adults with culture-proven candidaemia after July 1, 2018, and entered data into the ECMM Candida Registry (FungiScope CandiReg). We assessed ECMM Quality of Clinical Candidaemia Management (EQUAL Candida) scores reflecting adherence to recommendations of the European Society of Clinical Microbiology and Infectious Diseases and the Infectious Diseases Society of America guidelines. Findings 632 patients with candidaemia were included from 64 institutions. Overall 90-day mortality was 43% (265/617), and increasing age, intensive care unit admission, point increases in the Charlson comorbidity index score, and Candida tropicalis as causative pathogen were independent baseline predictors of mortality in Cox regression analysis. EQUAL Candida score remained an independent predictor of mortality in the multivariable Cox regression analyses after adjusting for the baseline predictors, even after restricting the analysis to patients who survived for more than 7 days after diagnosis (adjusted hazard ratio 1·08 [95% CI 1·04–1·11; p<0·0001] in patients with a central venous catheter and 1·09 [1·05–1·13; p<0·0001] in those without one, per one score point decrease). Median duration of hospital stay was 15 days (IQR 4–30) after diagnosis of candidaemia and was extended specifically for completion of parenteral therapy in 100 (16%) of 621 patients. Initial echinocandin treatment was associated with lower overall mortality and longer duration of hospital stay among survivors than treatment with other antifungals. Interpretation Although overall mortality in patients with candidaemia was high, our study indicates that adherence to clinical guideline recommendations, reflected by higher EQUAL Candida scores, might increase survival. New antifungals, with similar activity as current echinocandins but with longer half-lives or oral bioavailability, are needed to reduce duration of hospital stay.

Citovat

HOENIGL, Martin, Jon SALMANTON-GARCÍA, Matthias EGGER, Gangneux JEAN-PIERRE, Tihana BICANIC, Sevtap ARIKAN-AKDAGLI, Ana ALASTRUEY-IZQUIERDO, Nikolai KLIMKO, Aleksandra BARAC, Volkan ÖZENCI, Eelco F J MEIJER, Nina KHANNA, Matteo BASSETTI, Riina RAUTEMAA-RICHARDSON, Katrien LAGROU, Adam KAI-MANUEL, Emin Halis AKALIN, Murat AKOVA, Valentina Arsic ARSENIJEVIC, Avinash AUJAYEB, Ola BLENNOW, Stéphane BRETAGNE, François DANION, Blandine DENIS, Nick Alexander de JONGE, Guillaume DESOUBEAUX, Lubos DRGONA, Nurettin ERBEN, Andrea GORI, Julio García RODRÍGUEZ, Carolina GARCIA-VIDAL, Daniele Roberto GIACOBBE, Anna L GOODMAN, Petr HAMAL, Helena HAMMARSTRÖM, Cristina TOSCANO, Fanny LANTERNIER, Cornelia LASS-FLÖRL, Deborah E A LOCKHART, Thomas LONGVAL, Laura LOUGHLIN, Tadeja MATOS, Malgorzata MIKULSKA, Manjusha NARAYANAN, Sonia MARTÍN-PÉREZ, Juergen PRATTES, Benedict ROGERS, Laman RAHIMLI, Maite RUIZ, Emmanuel ROILIDES, Michael SAMARKOS, Ulrike SCHARMANN, Uluhan SILI, Oguz Resat SIPAHI, Alena SIVÁKOVÁ, Joerg STEINMANN, Janina TRAUTH, Ozge TURHAN, Jens Van PRAET, Antonio VENA, P Lewis WHITE, Birgit WILLINGER, Anna Maria TORTORANO, Maiken C ARENDRUP, Philipp KOEHLER and Oliver A CORNELY. Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study. The Lancet Infectious Diseases. OXFORD: ELSEVIER SCI LTD, 2023, vol. 23, No 6, p. 751-761. ISSN 1473-3099. Available from: https://dx.doi.org/10.1016/S1473-3099(22)00872-6.

@article{2268719,
   author = {Hoenigl, Martin and SalmantonandGarcía, Jon and Egger, Matthias and JeanandPierre, Gangneux and Bicanic, Tihana and ArikanandAkdagli, Sevtap and AlastrueyandIzquierdo, Ana and Klimko, Nikolai and Barac, Aleksandra and Özenci, Volkan and Meijer, Eelco F J and Khanna, Nina and Bassetti, Matteo and RautemaaandRichardson, Riina and Lagrou, Katrien and KaiandManuel, Adam and Akalin, Emin Halis and Akova, Murat and Arsenijevic, Valentina Arsic and Aujayeb, Avinash and Blennow, Ola and Bretagne, Stéphane and Danion, François and Denis, Blandine and Jonge, Nick Alexander de and Desoubeaux, Guillaume and Drgona, Lubos and Erben, Nurettin and Gori, Andrea and Rodríguez, Julio García and GarciaandVidal, Carolina and Giacobbe, Daniele Roberto and Goodman, Anna L and Hamal, Petr and Hammarström, Helena and Toscano, Cristina and Lanternier, Fanny and LassandFlörl, Cornelia and Lockhart, Deborah E A and Longval, Thomas and Loughlin, Laura and Matos, Tadeja and Mikulska, Malgorzata and Narayanan, Manjusha and MartínandPérez, Sonia and Prattes, Juergen and Rogers, Benedict and Rahimli, Laman and Ruiz, Maite and Roilides, Emmanuel and Samarkos, Michael and Scharmann, Ulrike and Sili, Uluhan and Sipahi, Oguz Resat and Siváková, Alena and Steinmann, Joerg and Trauth, Janina and Turhan, Ozge and Praet, Jens Van and Vena, Antonio and White, P Lewis and Willinger, Birgit and Tortorano, Anna Maria and Arendrup, Maiken C and Koehler, Philipp and Cornely, Oliver A},
   article_location = {OXFORD},
   article_number = {6},
   doi = {http://dx.doi.org/10.1016/S1473-3099(22)00872-6},
   keywords = {candidaemia; Europe},
   language = {eng},
   issn = {1473-3099},
   journal = {The Lancet Infectious Diseases},
   title = {Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study},
   url = {https://www.sciencedirect.com/science/article/pii/S1473309922008726?via%3Dihub},
   volume = {23},
   year = {2023}
}

TY  - JOUR
ID  - 2268719
AU  - Hoenigl, Martin - Salmanton-García, Jon - Egger, Matthias - Jean-Pierre, Gangneux - Bicanic, Tihana - Arikan-Akdagli, Sevtap - Alastruey-Izquierdo, Ana - Klimko, Nikolai - Barac, Aleksandra - Özenci, Volkan - Meijer, Eelco F J - Khanna, Nina - Bassetti, Matteo - Rautemaa-Richardson, Riina - Lagrou, Katrien - Kai-Manuel, Adam - Akalin, Emin Halis - Akova, Murat - Arsenijevic, Valentina Arsic - Aujayeb, Avinash - Blennow, Ola - Bretagne, Stéphane - Danion, François - Denis, Blandine - Jonge, Nick Alexander de - Desoubeaux, Guillaume - Drgona, Lubos - Erben, Nurettin - Gori, Andrea - Rodríguez, Julio García - Garcia-Vidal, Carolina - Giacobbe, Daniele Roberto - Goodman, Anna L - Hamal, Petr - Hammarström, Helena - Toscano, Cristina - Lanternier, Fanny - Lass-Flörl, Cornelia - Lockhart, Deborah E A - Longval, Thomas - Loughlin, Laura - Matos, Tadeja - Mikulska, Malgorzata - Narayanan, Manjusha - Martín-Pérez, Sonia - Prattes, Juergen - Rogers, Benedict - Rahimli, Laman - Ruiz, Maite - Roilides, Emmanuel - Samarkos, Michael - Scharmann, Ulrike - Sili, Uluhan - Sipahi, Oguz Resat - Siváková, Alena - Steinmann, Joerg - Trauth, Janina - Turhan, Ozge - Praet, Jens Van - Vena, Antonio - White, P Lewis - Willinger, Birgit - Tortorano, Anna Maria - Arendrup, Maiken C - Koehler, Philipp - Cornely, Oliver A
PY  - 2023
TI  - Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study
JF  - The Lancet Infectious Diseases
VL  - 23
IS  - 6
SP  - 751-761
EP  - 751-761
PB  - ELSEVIER SCI LTD
SN  - 14733099
KW  - candidaemia
KW  - Europe
UR  - https://www.sciencedirect.com/science/article/pii/S1473309922008726?via%3Dihub
N2  - Background The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, treatment, and outcomes of patients with culture-proven candidaemia across Europe to assess how adherence to guideline recommendations is associated with outcomes. Methods In this observational cohort study, 64 participating hospitals located in 20 European countries, with the number of eligible hospitals per country determined by population size, included the first ten consecutive adults with culture-proven candidaemia after July 1, 2018, and entered data into the ECMM Candida Registry (FungiScope CandiReg). We assessed ECMM Quality of Clinical Candidaemia Management (EQUAL Candida) scores reflecting adherence to recommendations of the European Society of Clinical Microbiology and Infectious Diseases and the Infectious Diseases Society of America guidelines. Findings 632 patients with candidaemia were included from 64 institutions. Overall 90-day mortality was 43% (265/617), and increasing age, intensive care unit admission, point increases in the Charlson comorbidity index score, and Candida tropicalis as causative pathogen were independent baseline predictors of mortality in Cox regression analysis. EQUAL Candida score remained an independent predictor of mortality in the multivariable Cox regression analyses after adjusting for the baseline predictors, even after restricting the analysis to patients who survived for more than 7 days after diagnosis (adjusted hazard ratio 1·08 [95% CI 1·04–1·11; p<0·0001] in patients with a central venous catheter and 1·09 [1·05–1·13; p<0·0001] in those without one, per one score point decrease). Median duration of hospital stay was 15 days (IQR 4–30) after diagnosis of candidaemia and was extended specifically for completion of parenteral therapy in 100 (16%) of 621 patients. Initial echinocandin treatment was associated with lower overall mortality and longer duration of hospital stay among survivors than treatment with other antifungals. Interpretation Although overall mortality in patients with candidaemia was high, our study indicates that adherence to clinical guideline recommendations, reflected by higher EQUAL Candida scores, might increase survival. New antifungals, with similar activity as current echinocandins but with longer half-lives or oral bioavailability, are needed to reduce duration of hospital stay.
ER  -

HOENIGL, Martin, Jon SALMANTON-GARCÍA, Matthias EGGER, Gangneux JEAN-PIERRE, Tihana BICANIC, Sevtap ARIKAN-AKDAGLI, Ana ALASTRUEY-IZQUIERDO, Nikolai KLIMKO, Aleksandra BARAC, Volkan ÖZENCI, Eelco F J MEIJER, Nina KHANNA, Matteo BASSETTI, Riina RAUTEMAA-RICHARDSON, Katrien LAGROU, Adam KAI-MANUEL, Emin Halis AKALIN, Murat AKOVA, Valentina Arsic ARSENIJEVIC, Avinash AUJAYEB, Ola BLENNOW, Stéphane BRETAGNE, Fran$\backslash$c cois DANION, Blandine DENIS, Nick Alexander de JONGE, Guillaume DESOUBEAUX, Lubos DRGONA, Nurettin ERBEN, Andrea GORI, Julio García RODRÍGUEZ, Carolina GARCIA-VIDAL, Daniele Roberto GIACOBBE, Anna L GOODMAN, Petr HAMAL, Helena HAMMARSTRÖM, Cristina TOSCANO, Fanny LANTERNIER, Cornelia LASS-FLÖRL, Deborah E A LOCKHART, Thomas LONGVAL, Laura LOUGHLIN, Tadeja MATOS, Malgorzata MIKULSKA, Manjusha NARAYANAN, Sonia MARTÍN-PÉREZ, Juergen PRATTES, Benedict ROGERS, Laman RAHIMLI, Maite RUIZ, Emmanuel ROILIDES, Michael SAMARKOS, Ulrike SCHARMANN, Uluhan SILI, Oguz Resat SIPAHI, Alena SIVÁKOVÁ, Joerg STEINMANN, Janina TRAUTH, Ozge TURHAN, Jens Van PRAET, Antonio VENA, P Lewis WHITE, Birgit WILLINGER, Anna Maria TORTORANO, Maiken C ARENDRUP, Philipp KOEHLER and Oliver A CORNELY. Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study. \textit{The Lancet Infectious Diseases}. OXFORD: ELSEVIER SCI LTD, 2023, vol.~23, No~6, p.~751-761. ISSN~1473-3099. Available from: https://dx.doi.org/10.1016/S1473-3099(22)00872-6.

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